Provider Demographics
NPI:1841317013
Name:FENSKE, JOEL ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ALAN
Last Name:FENSKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20700 CHIPPENDALE AVE W STE 7
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-8206
Mailing Address - Country:US
Mailing Address - Phone:651-460-9449
Mailing Address - Fax:612-326-9581
Practice Address - Street 1:20700 CHIPPENDALE AVE W STE 7
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024
Practice Address - Country:US
Practice Address - Phone:651-460-9449
Practice Address - Fax:612-326-9581
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN953150500OtherMN-ITS PROVIDER NUMBER
MN350003126Medicare ID - Type UnspecifiedPROVIDER NUMBER
MNU99845Medicare UPIN